Would Going to Psychologist Help my Chances of Getting Breast Reduction Covered by Insurance?

I have recently began the process of trying to get a breast reduction through my insurance company (switched to new insurance company). If I went to a psychologist and they wrote a report on the psychological effects my large breasts have had on me personally (anxiety, low self-confidence,ect.), do you think that would help me get my insurance company to cover the surgery? About me: 22, F-G cup (depends) I have the usual issues: back pains, shoulder pains, headaches, rashes, shoulder indentations

Doctor Answers 4

Psychologist helpful?

Almost everybody benefits from discussing their issues with a psychologist.  It is unlikely that the insurance company will take that into consideration because it is difficult for them to quantify the significance. Good luck.

Los Angeles Plastic Surgeon
4.9 out of 5 stars 54 reviews

As ridiculous as it sounds a psychologist opinion might persuade an insurance company to cover breast reduction.

Breast reduction is for the most part a functional procedure. A psychologist' s opinion might carry weight with the insurance company. Good luck, on that.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.8 out of 5 stars 36 reviews

Breast Reduction and Insurance

The key thing for you to do is have a conversation with your insurance company to find out what their policy on breast reduction coverage is.  Get it in writing and make sure you understand it completely.

Though this is only a generalization, our experience is that going to counseling doesn't help in many cases.  Most insurance companies need to be convinced that you have functional, physical problems that require reconstructive surgery, not cosmetic surgery.  Sometimes women are successful when they can provide documentation of trips to an orthopedic surgeon or chiropractor for neck and back pain, perhaps purchase of a back brace or other supportive device, treatment from their primary care physician for insomnia and prescription creams to deal with rashes. 

In short, your insurance company may consider covering all or part of a breast reduction if they consider it a good investment.  Unfortunately, no matter how much counseling might benefit you, chances are your insurance company will still consider breast reduction elective cosmetic surgery unless you can convince them otherwise.

Find out what they require, follow the list to the letter and be prepared to appeal if you are denied coverage.

Good luck,
Elliot Jacobs, M.D.

New York Plastic Surgeon

Elliot W. Jacobs, MD
New York Plastic Surgeon
4.5 out of 5 stars 35 reviews

Would Going to Psychologist Help my Chances of Getting Breast Reduction Covered by Insurance?

I am sorry to hear about the problems your breasts cause you. Based on your description, you will likely be a great candidate for breast reduction surgery. This operation tend to be some of the most patient pleasing operations we perform.

You will need to check with your insurance company directly to see whether your policy covers this operation.  They will be able to tell you whether psychiatric “support” will be helpful to when it comes to obtaining authorization. They will also be able to tell you whether you will have any direct responsibility/expenses if you choose to undergo this procedure.

The best way to obtain insurance coverage for breast reduction surgery involves some “hoops” to jump through. The more documentation you have (for example, from your primary care doctor, physical therapist, chiropractor etc.) the better when it comes to obtaining insurance “authorization” for the procedure.
 This documentation and letter/pictures from your plastic surgeon will help you obtain authorization.
   Also, be prepared to be persistent when dealing with health insurance companies.


I hope this, and the attached link, helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,498 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.